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I. How cops, EMS collaborate on innovative active shooter response

One city's pioneering approach to active-shooter response, featuring an exceptional level of cooperation between police and EMS, will be detailed this week at the annual convention of the International Assn. of Directors of Law Enforcement Standards and Training in Portland, OR.

The four trainers making the 2 1/2-hour presentation include Sgt. Craig Allen, training director for the Hillsboro (OR) PD and an early graduate of the certification course in Force Science Analysis.

According to Allen, the Force Science Institute's emphasis on research and realism in training has played a key role in developing Hillsboro's program, which he predicts "will become the international norm within the next three years."

In a series of pre-conference interviews with Force Science News, Allen outlined some of the salient aspects of Hillsboro's success in bridging the gap between agencies in a crisis response. The new strategy, he believes, will ultimately save innocent lives that might otherwise be lost.

PRIORITY SHIFT. Allen, with 20 years of law enforcement experience, began rethinking his department's approach to active shooters as a result of an ongoing research project he launched in 2007. Over a three-year period, he examined in depth scores of incidents of rapid mass murder and compiled evidence he felt compelled an emphatic change in priorities.

"When you look at all the data," he says, "you find that the huge majority of active shooter incidents are over by the time law enforcement is able to get involved, usually in 90 seconds to two minutes. Out of nearly 300 cases, I could find only 26 incidents where officers arrived from off-site in time to actually interrupt the killing and influence the outcome.

"It seemed that we were focusing our training effort and resources on a response strategy that had a positive effect only infrequently." In the meantime, what should be an important training consideration--how to get critically wounded victims who are still alive to emergency medical care in time to save them--seemed to be getting short shrift. From his research, Allen knew that it was not uncommon for 35 minutes to pass before EMS personnel made entry into a shooting scene.

"In effect," he says, "we were putting more lives at risk by ignoring the injured while we searched for an offender who had probably already stopped shooting, either because he'd killed himself, had fled, or had holed up in hiding."

What was needed, he concluded, was a strategy for "getting EMS into the scene simultaneously with a search for the shooter." And that, he judged, would require overcoming the traditional resistance of fire commanders to deploy their medical personnel into a setting that was not yet considered fully secured.

EMS DEPLOYMENT. In the spring of 2010, the Hillsboro Chamber of Commerce sponsored a special event at which local police officers demonstrated active-shooter response tactics and the fire department, independently, showed how it responds to mass-casualty crises. Afterward, having watched the cops run through their traces, fire trainer Jeff Gurske casually suggested in an email to Allen that the two agencies "should train together sometime." That opened a door that Allen charged through, already primed for a "paradigm shift" in strategy.

Across the next six months, PD and FD trainers worked together to hammer out the prototype of a collaborative approach to active-shooter calls. At its core is a concept Allen brought to the table from his military experience in the Marine Corps: the creation of a casualty collection point (CCP) inside the active-shooter site where EMS personnel can conduct triage on wounded survivors. Allen calls it "a bubble of warm zone within the hot zone."

Here's how it works:

Finding and neutralizing the assailant remains the Number 1 priority of the first responding officers. (In Hillsboro, a Portland suburb of nearly 100,000 population with a police force of 180 sworn, Allen estimates that officers typically can be inside a structure that's under siege within two minutes of the first call.) They enter and start to search as they arrive. Fire personnel, all of whom are EMS trained, are simultaneously dispatched to a staging area where the first arrivers prepare themselves and their equipment for imminent entry.

"Within five minutes, we'll have a real good idea what we're dealing with," Allen says. "If there's no sound of gunfire, chances are overwhelming that the suspect has killed himself or fled. I've found only three cases in which an active shooter hid himself and laid in wait to ambush responders."

The goal is to protectively escort EMS personnel in to a CCP within 10 to 12 minutes, Allen explains. "Inside, they're protected from the elements and are closer to where wounded victims are likely to be found."

While some officers ("the hunt team") continue searching for the shooter, others ("the rescue team") start carrying, dragging, or escorting the injured to the collection point for medical evaluation. "The faster we can get those victims to medical attention, the better the survival rate is likely to be. Shaving minutes can be vitally important," Allen says.

"Ideally, the CCP is an area large enough to accommodate multiple wounded, like a school gym or cafeteria or the lobby of an office complex," Allen explains. "It should have easy ingress and egress that can be protected, and a handful of officers should be able to take positions where they can provide counter-sniper over-watch of the CCP area."

By conducting organized triage at the CCP, Allen explains, the injured can be stabilized and transported to hospitals according to the severity of their wounds, and ERs are less likely to be overwhelmed by a sudden mixed in-surge of urgent and nonurgent patients.

Once fire officials understood the true nature of active shootings, as confirmed by his research, "they were on board with this strategy more easily than I expected," Allen says. "After all, they're accustomed to working in chaos in potentially dangerous surroundings, just like we are. Everything they do involves risk versus reward, so our job was to convince them that the rewards of quickly getting EMS inside could outweigh the risks. By walking them through real-world cases, we were able to demystify the typical active shooter call from being a monolithic, scary monster."

REALISTIC TRAINING. Part of the training for the new procedure involved a mutual familiarization with the operational aspects of the two services. "To break the ice, we let them drive our squad cars Code 3 and respond to a simulated active-shooter scenario, and they let us drive their fire trucks," Allen says. "We showed them some of the tactics of building searches, and they showed us the most efficient ways to carry or drag people with gunshot wounds, how best to apply a tourniquet, and how to clear the airway of someone who's not breathing.

"But we kept it clear that in practice our job is to hunt the assailant, provide protection for EMS, and bring the wounded to the CCP. Their job is triage and transport to get the wounded to definitive medical care."

Practical problems were worked out cooperatively during a series of limited field-training exercises. For example, squad cars responding to a designated shooter site were sometimes left in positions that blocked access by fire vehicles. Solution: since Hillsboro's police fleet is all keyed to the same ignition key, firefighters were each permanently issued a squad car key so they could move obstructing vehicles at will.

In December 2011 and again last January, the collaborative response strategy was tested in a massive training exercise, first in a middle school and more recently in a huge new medical center that was in the final stages of construction.

"Force Science stresses that in order to have the most effective impact on participants, training has to be as realistic as possible," Allen says. "We've done everything we could to make these test-runs super realistic."

At the medical center, for instance, 150 volunteer role players were recruited to participate. Nearly 30 of them were shooting "victims," taught to act as injured subjects would and with their "wounds" created by four Hollywood-trained moulage artists to depict various degrees of severity to test the triage expertise of medics in the CCP.

"Often in active shooter training," Allen notes, "the exercise starts at the point officers make entry into the crime site. To be more realistic, we had all responders begin at least two miles from the scene, doing what they'd normally be doing when they get the call. We wanted them to face the challenge of managing and coordinating their approach."

As soon as shots were fired, over a dozen role players were cued to call 911 with a barrage of excited and sometimes confusing/conflicting reports to realistically test the ability of the dispatch center. "Obviously, communications is a critical factor in an incident of this magnitude, and the 911 center approached this training with the same commitment to reality in order to truly test dispatcher protocols," Allen says.

Inside the shooting structure, trainers heightened the emotional stress of responders ("We stimulated their amygdala," Allen puts it) by detonating percussion grenades and igniting explosions of loud and smoky "IEDs" fashioned by a professional pyrotechnics expert. "We wanted the sights, sounds, and smells of a real-world event," Allen says. "Nothing was overly scripted, because unpredictability is an important part of reality."

In the course of six days at the medical center, about 500 emergency personnel, including some from outside agencies, were run through a simulated shooter crisis. "The response just blew us out of the water," Allen says. "We were now confident enough to finally put this approach officially into policy."

LOOKING AHEAD. "An active shooter is not just a police problem," Allen will tell the conference of POST executives this week. "There is a dire need for police and fire to work together in the interest of saving lives, and we are willing to share what we've learned with other agencies that are interested.

"We are now almost 15 years post-Columbine, and the law enforcement community is still debating how best to respond to these tragic events. It is inexcusable for police departments and fire departments not to put together an integrated response and train it to line personnel. It is time to move past squabbling over tactics, past obstructionists and interagency suspicion, and join together to reach common goals that will save lives."

For more information, Sgt. Allen can be reached at:craig.allen@hillsboro-oregon.gov. Our thanks to Scott Buhrmaster, operations vice president of the Force Science Institute, for bringing the Hillsboro program to our attention.

II. From our in-box: Is a policy always necessary?

In response to Force Science News transmission #229, in which we reported a court decision involving a police department that failed to have a policy and training about using force against injured persons:

It's disappointing that we live and work in a world where there needs to be a policy and training for everything. There are certainly situations where additional training is necessary, but the case described here is an excellent example of where the Graham standard can be applied.

Is it objectively reasonable to deliver a strike to the face of a person with a compound fracture under cervical spine restraint when that person is not doing anything but holding a closed knife and refusing to relinquish it? Given the available information, it should not be a mystery that it is not.

Ofcr. Brad Reinhard

Iowa City (IA) PD

Have comments, questions or insights to share with Force Science News? Drop us a note at: editor@forcescience.org